Capacitive Coupling Reduces Instrumentation-related Infection in Rabbit Spines: A Pilot Study

Abstract

Background Postoperative spine infections cause considerable morbidity. Patients are subjected to long-term antibiotic regimens and may require further surgery. Delivery of electric current through instrumentation can detach biofilm, allowing better antibiotic penetration and assisting in eradicating infection. Question/purposes We asked (1) whether capacitive coupling treatment in combination with a single dose of antibiotics would reduce infection rates when compared with antibiotics alone in a rabbit spine infection model, (2) whether it would decrease the overall bacterial burden, and (3) whether there was a time-dependent response based on days treated with capacitive coupling. Methods Thirty rabbits were subjected to a well-established spine infection model with a single dose of intravenously administered systemic ceftriaxone (20 mg/kg of body weight) prophylaxis. Two noncontiguous rods were implanted inside dead space defects at L3 and L6 challenged with 10 6

Bacterial biofilm formation on implantable devices and approaches to its treatment and prevention

“…showed the efficacy of non-homogenous electric fields (3–4 V/cm) to effectively control the P. aeruginosa and S. aureus growth rate and showed a synergistic effect when applied alongside chloramphenicol treatment [118]. Some studies have also demonstrated the effectiveness of a pulsed electromagnetic field (2000 μA, 1210–7500 V/cm) with increased number of pulses and pulsed electric field that leads to bacterial cell wall disintegration and internal alteration of the core in an in vitro and rabbit spine infection model, which also showed a synergistic effect with the antibiotic ceftriaxone [115, 119, 120, 121]. Studies have also shown the eradication of S. epidermidis , S. aureus and P. aeruginosa biofilms with the use of DC currents (1800 μA) [122, 123].…”

Electrical stimulation disrupts biofilms in a human wound model and reveals the potential for monitoring treatment response with volatile biomarkers

“…While the use of ES in wound care management is well established, we did not identify any previous studies assessing the impact of ES on wound biofilms in a human ex vivo model. Investigations of ES against biofilms in vivo are also sparse, with only six studies to date having assessed the effect of ES on biofilms, with the majority showing positive outcomes; however, none of these studies investigated the direct effect of ES on cutaneous wound bacterial biofilms.…”

Cathodic Voltage-controlled Electrical Stimulation Plus Prolonged Vancomycin Reduce Bacterial Burden of a Titanium Implant-associated Infection in a Rodent Model

“…This could be the result of disruption of the biofilm to release bacteria in the more vulnerable planktonic form or through a molecular or microenvironmental mechanism that is currently unknown. Although there have been numerous in vitro reports on the antimicrobial effects of direct electrical simulation with or without combination with antibiotics [3,6,8,9,17,18,24], there are only a few in vivo reports [7,13,23]. In contrast to the other in vivo models using electrical stimulation to treat implant-associated infections [7,13,23], CVCES uses a three-electrode configuration that allows us to precisely control the cathodic potential of the titanium implant [10,11].…”

“…Although there have been numerous in vitro reports on the antimicrobial effects of direct electrical simulation with or without combination with antibiotics [3,6,8,9,17,18,24], there are only a few in vivo reports [7,13,23]. In contrast to the other in vivo models using electrical stimulation to treat implant-associated infections [7,13,23], CVCES uses a three-electrode configuration that allows us to precisely control the cathodic potential of the titanium implant [10,11]. Although the exact antimicrobial mechanism of CVCES is not well understood, it is believed that cathodic modulation of Ti's voltage-dependent properties is one of the main driving factors for the robust antibacterial effects we have observed in our experiments [10,11,19].…”